异基因造血干细胞移植后T细胞再生及其临床意义

异基因造血干细胞移植包括已广泛开展的异基因骨髓移植（Ａｌｌｏ－ＢＭＴ）异基因外周血干细胞移植（Ａｌｌｏ－ＰＢＳＣＴ）以及脐带血血干细胞移植（ＣＢＴ）。它是治愈血液系统恶性肿瘤和其它多种疾病的有效手段。移植后在造血系统恢复的同时，免疫系统也在经历一个重建过程，Ｔ细胞再生通过胸腺依赖途径和胸腺非依赖途径。成人由于胸腺功能退化，Ｔ细胞再生更多是靠成熟Ｔ细胞的外周扩增和胸腺外分化，造成Ｔ细胞库多样性受限，

T-Cell Regeneration after Allogeneic Hematopoietic Stem Cell Transplantation and Its Significance

Allogeneic hematopoietic stem cell transplantation is curative therapy for many malignant hematologic and genetic disorders. The pathways by which T cell are regenerated in vivo are of central importance for host immune competence after the transplantation. Thymic-dependent and thymic-independent pathways of T-cell regeneration are primarily determined by thymus function, and that thymic-independent pathways are generally inadequate for restoration of host immunocompetence. T cell regeneration of adult recipients is largely through thymic-independent pathways due to reduced thymic regeneration capacity, resulting in quantitative defficiencies in T-cell number and severe restriction in the diversity of the regenerated T-cell receptor (TCR) repertoire. New strategies to enhance thymic function in man after BMT would hold great therapeutic potential. Activation of donor T cells is the cause of GVHD, the induction of anergy can inactivate specific sets of alloreactive T cells in the donor stem cells, which can prevent GVHD without inhibiting the entire T-cell repertoire.